Why am I so tired?

Do you ever feel exhausted even when you've had a good night's sleep? Maybe you struggle to get out of bed in the morning, feel sleepy in class or run out of energy when your friends still want to play.

If you have Crohn's disease or ulcerative colitis, feeling tired can be a common part of living with IBD.

You might hear people call this fatigue. It's more than feeling a little sleepy. Fatigue can make your whole body feel worn out, leaving you with very little energy to do the things you enjoy.

If this sounds like you, you're not lazy, and you're not imagining it. There are reasons why IBD can make you feel so tired, and there are ways to get help.

🔋 What is fatigue?

Fatigue is when you feel unusually tired, weak or exhausted, even after resting.

You might notice that you:

• Feel tired when you wake up, even after sleeping all night.

• Find it hard to concentrate at school.

• Run out of energy more quickly than your friends.

• Need to rest after doing things that usually feel easy.

• Feel too tired to play sport or see your friends.

• Get grumpy, frustrated or upset when you're exhausted.

Fatigue can look different for everyone. Some days, you might have plenty of energy. On other days, even getting dressed or walking around school can feel like hard work.

Being tired isn't a sign that you're not trying hard enough. Your body may be dealing with things that other people can't see.

🦠 How can IBD make me tired?

There isn't always just one reason for feeling exhausted. Several things related to IBD can affect your energy levels.

🔥 Inflammation in your bowel

When you have IBD, your immune system can cause inflammation in your digestive system.

Your body is working hard to manage that inflammation, and this can leave you feeling tired. You might experience fatigue during a flare, but inflammation can sometimes still be present even when your symptoms seem better.

🩸 Low iron

Iron helps your body make haemoglobin, which carries oxygen around your body in your blood.

If you have IBD, you might have low iron because of bleeding in your bowel, difficulties absorbing nutrients or not getting enough iron from your food.

If your iron levels become too low, you can feel exhausted, weak or dizzy. Low iron can also happen before you develop anaemia.

Your medical team can check your iron levels with blood tests and help you work out whether you need treatment.

🚽 Diarrhoea and dehydration

If you have frequent diarrhoea, your body can lose more fluid than usual.

Not having enough fluid can make you feel weak, dizzy and tired. It can also be harder to stay hydrated when you're unwell or struggling to eat and drink normally.

Drinking regularly and following your medical team's advice about replacing lost fluids can help.

🌙 Poor sleep

Tummy pain, needing the toilet during the night or worrying about your IBD can make it difficult to get enough good-quality sleep.

Even if you spend plenty of time in bed, broken sleep can leave you feeling exhausted the next day.

🍎 Not getting enough nutrients

When your bowel is inflamed, you might struggle to eat enough food or absorb certain nutrients.

Your body needs enough energy, protein, vitamins and minerals to grow, learn, play and recover.

If you're not getting what you need, it can contribute to feeling tired.

🏫 Why am I tired even when I feel well?

This can be one of the most frustrating things about having IBD.

You might not have tummy pain or diarrhoea anymore, so you expect to feel completely normal. But you're still exhausted.

There are a few possible reasons for this.

• You might still have inflammation in your bowel.

• Your iron levels might be low.

• Your body might still be recovering after a flare.

• You might not be sleeping well.

• You might be feeling stressed or worried.

Sometimes, several of these things happen together.

If you're still feeling very tired, tell your parent or carer. Your IBD team can help work out what's causing it rather than assuming it's just part of having IBD.

🎒 How can I manage tiredness at school?

Feeling tired at school can make everything harder. You might struggle to listen to your teacher, finish your work or keep up with your classmates.

Here are some things that might help.

• Tell your teacher. Let them know if you're struggling to concentrate or keep up because of fatigue.

• Take breaks when you can. Short breaks can help you manage your energy throughout the day.

• Break up big tasks. Doing a little work at a time can feel more manageable than trying to finish everything at once.

• Ask for help catching up. If you've missed school or need extra time, ask your teacher to help you make a plan.

• Rest after school. You might need some quiet time before doing homework, sport or other activities.

You don't need to push yourself to do everything your classmates do. It's okay to need extra support.

⚽ What if I'm too tired to play?

You might love sport, dancing, swimming or playing outside, but fatigue can sometimes make these activities feel impossible.

It can be disappointing when you want to join in but your body doesn't seem to have enough energy.

Try to listen to what your body is telling you.

• Choose activities that feel manageable on lower-energy days.

• Take breaks when you need them.

• Drink enough fluids, especially when you're active.

• Give yourself time to recover after exercise.

• Let your coach or teacher know if you need to slow down.

You don't have to give up the activities you love. You might just need to adjust how much you do on different days.

If you're unusually exhausted, dizzy or weak, stop and tell an adult. If fatigue is persistent or affecting your ability to participate in everyday activities, ask your parent or carer to contact your medical team.

🌙 What can I do to feel less tired?

There isn't one trick that works for everyone, but some everyday habits can support your energy levels.

🛏️ Make sleep a priority

Try to have a regular bedtime and wake-up time. Give yourself time to wind down before bed, and tell an adult if tummy symptoms or worries are keeping you awake.

🥪 Eat regularly

Your body needs enough food to grow and have energy. Try to eat regular meals and snacks that suit your needs and any advice from your dietitian.

If eating is difficult or you have been losing weight, tell your parent or carer and medical team.

💧 Drink enough fluids

Keep a water bottle nearby and drink regularly throughout the day. If you have diarrhoea, ask your medical team whether you need an oral rehydration solution to replace lost fluids and salts.

🧘 Take time to relax

Stress and worry can use up a lot of your energy. Listening to music, drawing, reading or spending time with someone you trust can help you unwind.

🩺 Keep up with your appointments

If fatigue continues, your medical team might check for inflammation, low iron, anaemia, nutritional deficiencies, sleep problems or other possible causes.

Getting the right treatment for the cause of your fatigue is often more helpful than simply trying to rest more.

💬 When should I tell someone?

It's important to tell your parent or carer if you're feeling tired a lot, especially if the tiredness is new, getting worse or stopping you from doing things you enjoy.

Let them know if you also have symptoms such as:

• Feeling dizzy or faint.

• Looking unusually pale.

• Becoming breathless more easily than usual.

• Having more diarrhoea or blood in your poo.

• Losing weight without trying.

• Struggling to get through a normal school day.

Your medical team may want to check your symptoms and arrange blood tests.

If you have severe weakness, fainting, difficulty breathing, significant bleeding or signs of severe dehydration, seek urgent medical care.

You don't need to wait until you're completely exhausted before asking for help.

💙 Remember, it's not your fault

Living with IBD can take a lot out of you, even when other people can't see it.

You might feel frustrated when your friends have energy to spare and you just want to lie down. You might feel guilty about missing sport or worry that people think you're being lazy.

But fatigue is real, and you deserve to be taken seriously.

You don't have to prove how tired you are, and you don't have to push through every difficult day.

Tell someone how you're feeling, give yourself permission to rest when you need to, and work with your medical team to find out what's causing your tiredness.

Your energy levels don't determine your worth. You're doing your best, and that's enough. 💙